Cardiac tamponade complicating thoracentesis in a patient after left pneumonectomy: A case report. Issue 15 (April 2020)

• Record Type: Journal Article
• Authors: Zheng, Mingxia; Kang, Yu; Wang, Tong; Wei, Jiafu
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 99:Issue 15(2020)
• Publication Date: 2020-04
• Subjects: cardiac tamponade -- complication -- thoracentesis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000019778
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Therapeutic or diagnostic thoracentesis is widely used in different clinical settings. Cardiac injury, a rare complication, could lead to fatal consequences. We describe a case of cardiac tamponade complicating thoracentesis that was recognized and rescued in a timely manner. Patient concerns: A 42-year-old woman underwent blind thoracentesis due to excessive left pleural effusion after left pneumonectomy surgery. She suddenly lost consciousness and was in a state of shock a few minutes after needle insertion and fluid drainage. Diagnosis: Bedside transthoracic echocardiography revealed pericardial effusion at a depth of 20 mm, and cardiac tamponade complicating thoracentesis was diagnosed. Interventions: After draining 250 mL of non-coagulated blood by pericardiocentesis under transthoracic echocardiography guidance, a tube was placed for continuous drainage over the subsequent 36 hours. Outcomes: The patient's hemodynamic condition was stabilized hours after pericardiocentesis. The patient was discharged in good condition a few days later. Lessons: Imaging assessment and guidance in the process of thoracentesis was indispensable, especially in a patient with altered intra-thoracic anatomy. Cardiac damage, as a life-threatening complication, should be considered once hemodynamic instability occurs during the procedure.